重复经颅磁刺激技术治疗抑郁症的研究与进展

Research and progression of repetitive transcranial magnetic stimulation in the treatment of depression

目的:重复经颅磁刺激(repetitivetranscranialmagneticstimulation,rTMS)是一项能够无创地干预脑功能的神经电生理技术。近年来,应用该技术治疗抑郁症的研究取得了很大进展,使其有望成为治疗抑郁症的有效手段之一。但患者因素、刺激部位、刺激参数的差异会对疗效造成不同程度的影响,就此问题进行综述。资料来源:应用计算机检索Medline1990-01/2004-10与rTMS和抑郁症相关文章,检索词“repetitivetranscranialmagneticstimulation(rTMS),depression并限定文章语言种类为English。资料选择:对资料进行初审,选取双盲随机对照的临床研究,筛除明显不随机或没有对照组的临床研究。资料提炼:共收集到31篇相关文献,其中20篇符合资料选择标准,排除的11篇中,9篇为个案报道或综述,2篇为Meta分析研究。资料综合:20篇文献共报道348例患者经rTMS治疗有效,26例无效。结论:重复经颅磁刺激技术是治疗抑郁症的有效手段,适当的患者、刺激部位及参数的选择可以提高疗效。

OBJECTIVE:Repetitive transcranial magnetic stimulation(rTMS) is a kind of neuroelectrophysiological technique that can interfere the function of human brain noninvasively.Studies from recent years show that rTMS has made much progression in the treatment of depression,which makes this technique a prospective therapy for depression.However,the differences in patients' factors,stimulation and stimulation parameters influence the therapeutic effects at different degrees,which will be reviewed in the following study. DATA SOURCES:English-language studies about rTMS therapy and depression between January 1990 and October 2004 were searched for in Medline database by using the key words of “repetitive transcranial magnetic stimulation,depression'. STUDY SELECTION:After primary examination,the randomized and double-blind controlled trials were selected,excluding the obvious non-randomized or non-controlled clinical studies. DATA EXTRACTION:Totally 31 relevant literatures were collected.Of the 31 literatures,20 studies were according with the selection criteria for data and 11 were excluded because of case-report or review(9 articles) and Meta analytic studies(2 articels). DATA SYNTHESIS:rTMS improved depressive symptoms in 348 patients with depression and was ineffective on 26 patients reported by the 20 articles. CONCLUSION:rTMS is an effective treatment tool for depression,and proper patients' factors,stimulation positions and parameters can increase the clinical efficacy of rTMS.